ICAR Medcom Spring meeting

Transcription

1 International Commission for Mountain Emergency Medicine (ICAR MEDCOM) c/o Fidel Elsensohn, MD + Schloesslestr Roethis + Austria fidel.elsensohn@aon.at + M: ICAR Medcom Spring meeting 3-7 May 2017, Porto Venere, Liguria Italy List of participants Fabien Argenone (France) Enrico Donegani (UIAA Medcom) Fidel Elsensohn (President, Austria) John Ellerton (Vice President, UK) Giancecso Agazzi (Italian alpine club, Italy) Marc Blancher (ANMSM, France) Herman Brugger (EURAC, Italy) Gian Luca Facchetti (Guest, Italy) Luigi Festi (Italian Alpine Club, Italy) Julia Fieler (Norwegian Red Cross, Norway) Natalie Hölzl (BExMed, Germany) Alex Kottman (Rega/ARS, Switzerland) Mario Milani (CNSAS, Italy) Peter Paal (Bergrettungsdienst im Alpenverein Südtirol, Italy) Mathieu Pasquier (Emerg. Service Lausanne Chuv, Switzerland) Oliver Reisten (OCVS/KWRO, Switzerland) Johannes Schiffer (Bergwacht Bayern, Germany) Inigo Soteras (Hospital Cerdanya, Spain) Giacomo Strapazzoni (CNSAS, Italy) Günter Sumann (OEGAHM, Austria) Iztok Tomazin (GRZS, Slovenia) 1/9

2 Apologies: Mike Greene (MR England & Wales, UK) Corrina Schön (Switzerland) Grégoire Zen Ruffinen (OCVS, Switzerland) Volker Liscke (Bergwacht, Germany) Marie Nordgren (Sweden) Kazue Oshiro (JSMM Japan) Sven C Skaiaa (Norway) Monika Brodmann (Switzerland) Welcome: Our Italian friends, Luigi Festi and Mario Milani, welcomed us and outlined the programme. Thanks to the Medical Commission of Club Alpino Italiano and CNSAS for their generous support. We were honoured to celebrate Luigi's 60th birthday with a great dinner. The minutes of the ICAR Medcom meeting at Boverets, Bulgaria 2016 were accepted. President s report: The death of one of the icons of mountain rescue, Dr Bruno Dürer, was recalled and marked. There was dismay that ICAR data collection was to stop. We recognised the problems in data collection but felt it should really happen. Perhaps Type A members should be mandated to provide the data or face a penalty? Current papers and projects: The canyon paper was further refined. Its contents had been agreed in the Fall meeting, so it was agreed that the final version would be posted on the web platform with a 2 wk consultation period. The paper could then start the process of journal submission if no major disagreement arose. 2/2

3 An update on the MCI paper was given by Marc. A systematic review had been done, the tables of incidents enlarged as members had passed on details. Ken s section had been received and Mike and Kyle were doing the English. A 4 wk final review period on the web platform was agreed. New papers: Quality Indicators in Avalanche Rescue The Retrospective study of medical requirements for avalanche rescue missions was presented by Alex Kottmann. The work was part of his MD thesis. Using the REGA database of missions ( ), inclusion criteria of avalanche, <24 hrs, one person were applied (422 avalanches, 596 patients). The avalanche missions account for 0.5% of 1º missions, and only 2 bases had >5/yr. The maximum physician exposure was <20 in 15 yrs, and only 5% of physicians saw at least one case in a year! Response time 22 min; cardiac arrest (single victim) 29%, (multi-victims) 5%; burial time 35min, burial depth 1m; winch used 29%; presumptive injury pattern trauma 47%, hypothermia 31%, asphyxia 17%. Alex and Mathieu proposed using a modified nominal group technique to develop a template and quality indicators to enable organisations to benchmark themselves and improve decision-making and outcome. (Fattah et al. See The plan is to define the study (Andorra, Oct 2017), consensus meeting (Spring 2018), presentation Chamonix (Oct 2018). A short video/audio for rescue and hospital Health Care Professionals (HCP) on optimal management of an avalanche accident was suggested so a reminder can be quickly reviewed as the mission was being planned or waiting for patients to be received. Management of Multiple Trauma and Shock Peter Paal proposed that the Shock paper be updated and title 3/2

4 changed to Management of Multiple Trauma. Peter will define a group of authors offers of help to Peter please a structure and timeline in October. Current projects: Knowledge base project Natalie Hölzl discussed this project. A working group of 6 had been set up. The aim was to develop an ICAR Medcom e-learning resource. Further discussion was postponed to the Fall. We need to be mindful that development should be co-ordinated with MEM book and ICAR knowledge base. The project was fully supported. New projects: Mountain Emergency Medicine (MEM) book Proposed by Herman Brugger and Luigi Festi. Addressed to Health Care Professionals, a publisher has been found (Elsevier/Edra/Masson group in Milan, Italy. A hard cover and e-book were envisaged. Its distinct features would be practical but based on evidence, comprehensive yet concise, easily readable and illustrative. British-English and Spanish. Editors: Hermann, Luigi, John, Peter, and 1 other. Authors for 19 chapters (47 subchapters) discussed. Timeline ideally to publish by the ISMM Kathmandu 2018! Register and analysis of rescuer death s Iztok Tomazin raised this issue. John explained he had been trying to stimulate interest in other sub-commissions through the Executive Board for a number of years. He had envisaged a small group drawn from all of the sub-commissions that would analyse and record rescuer s deaths during training and missions. It would use public data in the first instance to mitigate against privacy laws. Iztok will liaise with Dušan Polajnar (EC board member) to try to get the subject raised at the ICAR Assembly of 4/2

5 Delegates in Andorra. Short presentations: Rigopiano s avalanche/earthquake 2017 Gian Luca Facchetti described this accident in Central Italy. 2.5m x 800m avalanche triggered by an earthquake, known avalanche site, engulfed an isolated hotel. Involved 40 persons, 38 missing. No mobile phones but internet working. Alert via 118 and then What s App. Delay from official not believing report. 20 km snow plough - very slow because of fallen trees. 3 persons detected by probes, 6 alive under rubble, use of IMSI Catcher to locate mobile phones. Most victims were in the building, a number known t be alive for a considerable period after the avalanche. Full pathology of the 29 persons that died will become available. Of the survivors, 1 had a compressive injury to their limbs, no hypothermia. Some of the rescuers involved, including 2 HCP, died a few weeks later in a helicopter crash whilst rescuing an injured skier. CNSAS complex emergency interventions Simone Marcuzzi presented these ranging from snow clearing to earthquakes and avalanches. Search experience over large areas with large numbers of rescuers is invaluable. He also described the G.E.Co development of an App that allows a person to contact CNSAS directly in an emegerency. 27,000 persons have bought the App. UIAA Medcom report Enrico Donegani presented recent developments. The drug paper had had 10,000 hits. The next UIAA Medcom meeting was to be at the WMS in Kathmandu Rianne, David and George were confirmed as the members on the DiMM administrative board. 5/2

6 Central Apennines Earthquake, Italy August 2016 Mario presented CNSAS s experiences from this incident volunteers including 250 Health Care Professionals involved. 298 dead, 388 injured. Communication problems radio channels different, mobiles are better. Loss of institutional memory (of earthquakes). Wrist bands for the victims would be better than cards. HEMS-EURAC mountain emergency medicine course Giacamo reported that an English version would be run next year. There were too many participants on the last course. Priority to be given to HEMS crew. Forthcoming Events: 2017, October: ICAR General Assembly Andorra Pre-conference day: see draft Preliminary ICAR Medcom programme: (see draft attached to the minutes Election of president-elect (see footnote). New papers structure of multi-trauma, suspension syndrome, QI in Avalanche rescue. Projects knowledge base, MEM book, International registries. Communications Snow density, avalanche CPR, Monte Carlo simulations Preliminary ICAR Congress programme: Rigopiano Avalanche, Canyon guidelines, First Aid, Suspension trauma? 2018, ICAR Medcom Spring meeting: Tromso, Norway Special interest hypothermia hopefully with hospital and research input. Julia and Alex will explore the idea 2018, October: ICAR General Assembly Chamonix, France 6/2

7 2018, (19) November: World Congress of Mountain Medicine Yak-Yeti Hotel, Kathmandu, Nepal. Preliminary programme: Pre-conference th Hands on techniques in MR/DiMM instructors training course (Monika)/Assessment and feedback/mem workshops, 22 nd MEM, 23 rd HAMB, 24 th Travel and Expedition 2019, ICAR Medcom Spring meeting Hermann s climate chamber, Bolzano, Italy 2019, October: ICAR General Assembly Zakopane, Poland 2020, October: ICAR General Assembly Thessaloniki, Greece (Footnote: John outlined his thoughts on becoming President after the Oct meeting. To build on the work of Hermann and Fidel; strengthen mountain emergency research by making ICAR Medcom an essential hub and collaborator; develop knowledge/training for all HCP (via DiMM/DiEMM) and mountain rescuers; restructure Spring meetings to reach out to continents that remain on the periphery of ICAR and learn from others by defining a special topic such as drowning, disaster, occupational, etc.; streams of work/teaching at the Fall meeting; development of Skype type small group meetings; routinely use the annual sub-commission budget) Minutes taken by John Ellerton 7/2

8 International Commission for Mountain Emergency Medicine (ICAR MEDCOM) Fall meeting 2017 Soleu, Andorra, Oct Program Draft 1) Pre-Conference Day: ICAR MEDCOM is invited to organize 1 or 2 stations by TERCOM. Location will be around in the mountains a) Suspension Trauma (directly relevant to the general theme) i) Who will take the lead: Inigo Soteras ii) assisted by: Oliver Reisten, Natalie Hölzl, Johannes Schiffer, Fidel, iii) Material: Inigo b) Trauma treatment: Reduction of dislocations (directly relevant to the general theme) 2) ICAR MEDCOM Meeting: a) New papers and discussion i) skipatrollers and mtn rescuers psychosocial health PTSD in Sweden (Marie Nordgren) ii) Management in Traumatic shock structure and proposal 1h (Paal iii) Suspension trauma (Brugger) 1 h iv) International Avalanche and trauma registry (2h) M. Brodmann v) Mountain Medicine Data base (N. Hölzl) (0,5 h) vi) Qualitiy Indicators in Avlanche Rescue (Kottmann) b) Short communications i) Snow densitiy study (Strapazzon) ii) Avalanche CPR iii) Potassium Cutoff level in avalanche victims (Brugger) iv) Monte Carlo Simulation (M.Genswein) v) "Cause of death in avalanche fatalities in Colorado, a 20 year review" (Alison Sheets MD, MRA Colorado) 15 min c) Election of new President of ICAR MEDCOM (John Ellerton) d) Election of Vice Presidents e) Discussion on the proposal of a Diploma course for instructors for the DiMM 3) Presentations at ICAR Congress: Saturday morning: total 60 min i) Canyoning guidelines (I Soteras) ii) First aid Kit (O Reisten) iii) Suspension trauma (Eurac) iv) The Rigopiano Disaster (M. Milani, Gianluca Facchetti) 4) Election of New ICAR MEDCOM President Dr. John Ellerton by AoD 8/2

9 International Commission for Mountain Emergency Medicine ICAR MEDCOM SPRING MEETING PORTO VENERE, ITALY May 3 7, 2017 Certification of attendance I certify that Dr. attended the meeting of the INTERNATIONAL COMMISSION FOR MOUNTAIN EMERGENCY MEDICINE as official member of The meeting was held from May 3-7, 2017 in Porto Venere, Italy President Fidel Elsensohn MD Porto Venere, May 7, /2